Luke K Bolt1, G Paul Amminger2, John Farhall3, Patrick D McGorry4, Barnaby Nelson5, Connie Markulev6, Hok Pan Yuen7, Miriam R Schäfer8, Nilufar Mossaheb9, Monika Schlögelhofer10, Stefan Smesny11, Ian B Hickie12, Gregor Emanuel Berger13, Eric Y H Chen14, Lieuwe de Haan15, Dorien H Nieman16, Merete Nordentoft17, Anita Riecher-Rössler18, Swapna Verma19, Andrew Thompson20, Alison Ruth Yung21, Kelly A Allott22. 1. Department of Psychology and Counselling, La Trobe University, Bundoora, Australia. 2. Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia; Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria. Electronic address: paul.amminger@orygen.org.au. 3. Department of Psychology and Counselling, La Trobe University, Bundoora, Australia. Electronic address: j.farhall@latrobe.edu.au. 4. Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia. Electronic address: pat.mcgorry@orygen.org.au. 5. Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia. Electronic address: barnaby.nelson@orygen.org.au. 6. Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia. Electronic address: connie.markulev@orygen.org.au. 7. Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia. Electronic address: hokpan.yuen@orygen.org.au. 8. Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria. 9. Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria. Electronic address: nilufar.mossaheb@meduniwien.ac.at. 10. Department of Child and Adolescent Psychiatry, Medical University Vienna, Vienna, Austria. Electronic address: monika.schloegelhofer@meduniwien.ac.at. 11. Department of Psychiatry, University Hospital Jena, Jena, Germany. Electronic address: stefan.smesny@med.uni-jena.de. 12. Brain and Mind Centre, University of Sydney, Sydney, Australia. Electronic address: Ian.hickie@sydney.edu.au. 13. Child and Adolescent Psychiatric Service of the Canton of Zurich, Zurich, Switzerland. Electronic address: gregor.berger@puk.zh.ch. 14. Department of Psychiatry, University of Hong Kong, Hong Kong. Electronic address: eyhchen@hkusua.hku.hk. 15. Department of Psychiatry, Amsterdam University Medical Centers, the Netherlands. Electronic address: l.dehaan@amc.uva.nl. 16. Department of Psychiatry, Amsterdam University Medical Centers, the Netherlands. Electronic address: d.h.nieman@amc.uva.nl. 17. Psychiatric Centre Bispebjerg, Copenhagen, Denmark. Electronic address: merete.nordentoft@regionh.dk. 18. Psychiatric University Clinics Basel, Basel, Switzerland. Electronic address: anita.riecher@upkbs.ch. 19. Institute of Mental Health, Singapore, Singapore. Electronic address: swapna_verma@imh.com.sg. 20. Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, England, United Kingdom of Great Britain and Northern Ireland; North Warwickshire Early Intervention in Psychosis Service, Coventry and Warwickshire National Health Service Partnership Trust, Coventry, England, United Kingdom of Great Britain and Northern Ireland. Electronic address: andrew.d.thompson@warwick.ac.uk. 21. Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; Division of Psychology and Mental Health, University of Manchester, Manchester, United Kingdom of Great Britain and Northern Ireland; Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom of Great Britain and Northern Ireland. Electronic address: alison.yung@manchester.ac.uk. 22. Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Australia; The Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia. Electronic address: kelly.allott@orygen.org.au.
Abstract
BACKGROUND: Neurocognitive impairments experienced by individuals at ultra-high risk (UHR) for psychosis are potential predictors of outcome within this population, however there is inconsistency regarding the specific neurocognitive domains implicated. This study aimed to examine whether baseline neurocognition predicted transition to psychosis, or functional outcomes, at medium-term (mean = 3.4 years) follow-up, while controlling for other clinical/treatment variables associated with transition to psychosis. METHOD: Analysis of data collected as part of a multi-centre RCT of omega-3 fatty acids and cognitive-behavioural case management (NEURAPRO) for UHR individuals was conducted on the 294 participants (134 males, 160 females) who completed neurocognitive assessment (Brief Assessment of Cognition for Schizophrenia) at baseline. Transition to psychosis was determined using the Comprehensive Assessment of At-Risk Mental States (CAARMS), and functioning was measured with the Global Functioning: Social and Role Scales. RESULTS:Mean baseline z-scores indicated that UHR participants performed a quarter to half a standard deviation below normative means in all domains (range mean z = -0.24 to -0.47), except for executive functioning (mean z = 0.16). After adjusting for covariates, poorer Executive (p = .010) and Motor (p = .030) functions were predictive of transition to psychosis. Processing Speed and Verbal Fluency were significant predictors of role functioning at 12 months (p = .004), and social functioning at medium-term follow-up (p = .015), respectively. CONCLUSIONS:Neurocognitive abilities are independent predictors of both transition to psychosis and functional outcomes within the UHR population. Further research is needed to determine the best combination of risk variables in UHR individuals for prediction of psychosis transition, functioning and other psychopathology outcomes.
RCT Entities:
BACKGROUND:Neurocognitive impairments experienced by individuals at ultra-high risk (UHR) for psychosis are potential predictors of outcome within this population, however there is inconsistency regarding the specific neurocognitive domains implicated. This study aimed to examine whether baseline neurocognition predicted transition to psychosis, or functional outcomes, at medium-term (mean = 3.4 years) follow-up, while controlling for other clinical/treatment variables associated with transition to psychosis. METHOD: Analysis of data collected as part of a multi-centre RCT of omega-3 fatty acids and cognitive-behavioural case management (NEURAPRO) for UHR individuals was conducted on the 294 participants (134 males, 160 females) who completed neurocognitive assessment (Brief Assessment of Cognition for Schizophrenia) at baseline. Transition to psychosis was determined using the Comprehensive Assessment of At-Risk Mental States (CAARMS), and functioning was measured with the Global Functioning: Social and Role Scales. RESULTS: Mean baseline z-scores indicated that UHR participants performed a quarter to half a standard deviation below normative means in all domains (range mean z = -0.24 to -0.47), except for executive functioning (mean z = 0.16). After adjusting for covariates, poorer Executive (p = .010) and Motor (p = .030) functions were predictive of transition to psychosis. Processing Speed and Verbal Fluency were significant predictors of role functioning at 12 months (p = .004), and social functioning at medium-term follow-up (p = .015), respectively. CONCLUSIONS: Neurocognitive abilities are independent predictors of both transition to psychosis and functional outcomes within the UHR population. Further research is needed to determine the best combination of risk variables in UHR individuals for prediction of psychosis transition, functioning and other psychopathology outcomes.
Authors: Louise B Glenthøj; Lise S Mariegaard; Birgitte Fagerlund; Jens R M Jepsen; Tina D Kristensen; Christina Wenneberg; Kristine Krakauer; Alice Medalia; David L Roberts; Carsten Hjorthøj; Merete Nordentoft Journal: World Psychiatry Date: 2020-10 Impact factor: 49.548
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Authors: Raimo K R Salokangas; Tiina From; Tuula Ilonen; Sinikka Luutonen; Markus Heinimaa; Reetta-Liina Armio; Heikki Laurikainen; Maija Walta; Janina Paju; Anna Toivonen; Päivi Jalo; Lauri Tuominen; Jarmo Hietala Journal: BMC Psychiatry Date: 2021-12-02 Impact factor: 3.630
Authors: Caroline Ranem Mohn-Haugen; Christine Mohn; Frank Larøi; Charlotte M Teigset; Merete Glenne Øie; Bjørn Rishovd Rund Journal: Schizophr Res Cogn Date: 2022-03-01
Authors: Emily P Hedges; Hannah Dickson; Stefania Tognin; Gemma Modinos; Mathilde Antoniades; Mark van der Gaag; Lieuwe de Haan; Patrick McGorry; Christos Pantelis; Anita Riecher-Rössler; Rodrigo Bressan; Neus Barrantes-Vidal; Marie-Odile Krebs; Merete Nordentoft; Stephan Ruhrmann; Gabriele Sachs; Bart P Rutten; Jim van Os; Lucia R Valmaggia; Philip McGuire; Matthew J Kempton Journal: Schizophr Res Cogn Date: 2021-10-28